Amongst 112 patients with a total of 122 intracranial aneurysms, there were eleven (9%) in the vertebro-basilar system. Four of the vertebral artery aneurysms were situated at the origin of the inferior posterior cerebellar artery, three at the bifurcation of the basilar artery; there were three rare aneurysms situated peripherally on the cerebellar vessels and there was one circumscribed aneurysm of the basilar artery stem. Selective vertebral angiography, with high position of the catheter, is recommended for the demonstration of these aneurysms. If there is insufficient reflux into the opposite vertebral artery from a left-sided injection, bilateral vertebral angiography must be carried out. Special projections, such as transoral (open-mouth) or transfacial may be of advantage. Angiotomography has also proved valuable and magnification can be helpful. Subtraction is particularly indicated for sagittal projections.